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REPORT ON THE REGIONAL EXPERT FORUM ON POPULATION AGEING

12 – 13 JULY 2016

BANGKOK THAILAND

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Copyright © United Nations, Bangkok 2016

All rights reserved

Social Development Division

United Nations Economic and Social Commission for Asia and the Pacific

United Nations Building

Rajadamnern Nok Avenue

Bangkok 10200 Thailand

E-mail: escap-sdd@un.org

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Contents I. Background ................................................................................................................................. 4

II. Overview and objectives of the Regional Expert Forum ..................................................... 5

III. Long-term care for older persons in the Asia-Pacific region ............................................... 6

IV. Process of the Third review of the Madrid International Plan of Action on Ageing ..... 11

V. Identifying regional priorities for the implementation of the Madrid International Plan

of Action on Ageing and emerging areas ............................................................................................. 13

Advancing health and well-being into old age ................................................................................ 13

Older Persons and Development with a focus on income security .............................................. 15

Ensuring enabling and supportive environments including families .......................................... 17

VI. Recommendations ................................................................................................................... 21

VII. Closing of the Regional Expert Forum ................................................................................. 24

Annex I List of Participants ................................................................................................................... 25

Annex II Programme .............................................................................................................................. 30

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I. Background

The Regional Expert Forum on Population Ageing was held on 12 and 13 July 2016 in the UN Conference Center, Bangkok. It was organized by the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), in cooperation with the National Health and Family Planning Commission of China (NHFPC), within the context of the project “Strengthening national capacity for promoting and protecting the rights of older persons”.

The Regional Expert Forum on Population Ageing builds on the outcomes of prior expert meetings under the same project, including the Regional Expert Consultation on Long-term Care of Older Persons held on 9 and 10 December, 2014 in Bangkok and the Asia-Pacific Expert Group Meeting on Long-Term Care, held in Shanghai on 18 and 19 December 2013.

The Regional Expert Forum on Population Ageing was attended by Government focal points on population ageing, policy-makers, development practitioners, independent experts, and civil society representatives in the Asian and Pacific region (see Annex I for a list of participants).

The partner organizations that are involved in the review process of the Madrid International Plan of Action on Ageing - such as UNFPA, WHO, ILO and HelpAge International - further served as partners in the Regional Expert Forum on Population Ageing.

The objectives of the meeting were:

(1) To review and share good practices in addressing the long-term care needs of older persons in the region and to consider policies to formulate a comprehensive framework for long-term care of older persons in the region;

(2) To increase awareness on the key challenges and opportunities for effectively addressing population ageing and promoting the rights of older persons in the Asia- Pacific region in the context of the forthcoming Third Regional Review of the Madrid International Plan of Action on Ageing;

(3) To agree on a strategy to assess progress at regional and country level on the implementation of the Madrid International Plan of Action on Ageing (MIPAA), including proposing concrete follow-up actions within the framework of the 2030 Agenda for Sustainable Development and the Sustainable Development Goals (SDGs).

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II. Overview and objectives of the Regional Expert Forum

Opening remarks were made by Mr. Srinivas Tata, Chief, Social Policy and Population Section, United Nations Economic and Social Commission for Asia and the Pacific (ESCAP); Ms. Mo Lixia, Deputy Director General, Department of Family Development, National Health and Family Planning Commission, China; Ms. Yoriko Yasukawa, Regional Director, UNFPA, and Mr. Eduardo Klien, Regional Director, HelpAge International.

Her Excellency Rosy Sofia Akbar, Minister for Women, Children and Poverty Alleviation of Fiji delivered a keynote speech on Population ageing in Asia and the Pacific – challenges, opportunities and gender aspects, where after she formally opened the meeting. H. E. Akbar emphasized the need to strive for an inclusive, protective and healthy environment, and – as the benchmark – uphold the Human Rights-Based Approach to Development. She stated that countries in Asia and the Pacific “must unite as a region to share challenges and opportunities that will enable countries to meet the needs of the growing population of older persons. It was argued that the policy reform needed would review the policy design from a life cycle perspective: Systems segmentation related to health and welfare policies should be addressed in conjunction with appropriate responses to other challenges, such as climate change, food security, lack of access to ICTS, and non-communicable diseases.

Ms Channe Lindstrøm Oğuzhan, Associate Social Affairs Officer, ESCAP, briefly outlined the background, main objectives and the programme for the Regional Expert Forum. She explained that the Forum consisted of two interrelated parts. Part I focused on discussing the key outcomes of analytical studies conducted on the status of long-term care in selected countries in the region as part of a project funded by the National Health and Family Planning Commission of China. Part II discussed the Third Regional Review of the Madrid International Plan of Action on Ageing (MIPAA) planned for late 2017 and identified and discussed priority areas, challenges, and emerging areas in implementation of MIPAA.

The Forum adopted an interactive format with the active involvement of policy makers and experts from within the region. Presentations, panel discussions and group work were used to introduce critical issues and stimulate discussions.

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III. Long-term care for older persons in the Asia-Pacific region

The session on long-term care for older persons in the Asia-Pacific Region was moderated by Mr. Srinivas Tata (ESCAP) and featured an interactive panel discussion with questions to highlight national experiences and key elements for policy guidance on the critical issues faced by countries in providing long-term care for older persons. The discussion was informed by six policy papers covering China, India, Japan, the Republic of Korea, Singapore, Sri Lanka, and Thailand. The panel consisted of Mr. Du Peng, Professor, Renmin University, China; Ms. Peh Kim Choo, Tsao Foundation, Singapore; Ms. Siriphan Sasat, Associate Professor, Chulalongkorn University, Thailand; Dr. Aparajit Ballav Dey, Professor, All India Institute of Medical Sciences, India; and Dr. Wendy Holmes, International Public Health Consultant, Sri Lanka.

The panel noted that the Asia-Pacific region is experiencing population ageing at

an unprecedented pace, with the number of older persons – defined as the population of 60 years and older - expected to almost triple from 514 million in 2015 to more than 1.31 billion by 2050. By then, one in four people in the region will be over 60 years old, while the “oldest-old”, those above 80 years of age, will constitute about one-fifth of all older persons. Due to the longer life expectancy for women, the majority of older persons are women, with the sex ratio decreasing the older the age group. This demographic transition towards an ageing society in the Asia-Pacific region has profound social, economic, and political implications.

As the population grows older, the need for long-term care services is expected

to increase considerably. With changing family structures, rural-urban migration and women increasingly taking part in the labour market, the family can no longer be relied on as the primary source of care and support for older persons. Already during the Asia-Pacific consultations held in preparation for the second review and appraisal of the Madrid International Plan of Action on Ageing (MIPAA) in 2012, the limited capacity to meet the rising demands for elderly care services was identified as one of the critical challenges for the region.

Mr. Du Peng noted that while ageing now forms part of China’s five year plan,

the provision of community care remains a challenge even though it was the preference of many older persons. While definitive policy progress had been made, the quality of care needed to be improved, especially for those requiring long-term care: A 2010 national survey revealed that 3 per cent of older persons in Beijing have serious health problems and depend on a caregiver. The new five year plan expects about 3 per cent of older persons to be in institutional care, 7 per cent in community-based care and 90 per cent to be taken care of at home. It is however important to progressively improve community-care structures in order to deliver services effectively.

Mr. Du Peng also outlined some of the main challenges that China currently faces.

Firstly, younger family members are bearing the responsibility of taking care of older persons due to the traditional Asian culture of filial piety. However, such family support will not satisfy the increasing needs of long-term care, in view of the increase in the number of working women, rapidly aging populations, and migration of younger family

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members to urban areas. Secondly, the provision of long-term care to all older persons will require the government to develop and implement policies related to long-term health care in an integrated manner. He also pointed out that China had to consider how to enable both civil society and private sector actors to participate in the delivery of health and long-term care programs. Since a significant number of older persons in China, especially in rural areas, received health services and consultation through volunteering programs with the help from NGOs, it is important to effectively manage the engagement of NGOs as caregivers within the context of the health care system.

Ms. Choo reflected on the changing family structure in Singapore and its impact

on the provision of long-term care for older persons. The families have grown increasingly urbanized, and smaller in size. There are also many single peoples’ households. Although in Singapore, the main responsibility of care provision is still with the family, this had to be reconsidered in light of above changes. Older persons with disabilities, or in otherwise need of medical services, will also need to be addressed within such revised framework. In addition to physical care, Ms. Choo also stated that the emotional needs of older persons should be increasingly paid attention to, which had to be taken care of by the family, but now new ways had to be found. In this social context, Singapore is moving towards community-based care, and subsequently towards the closer integration of medical and social care.

Ms. Choo further explained that Singapore had established a specific agency

responsible for the coordination of care, as long-term care was not set in a vacuum; it had to be provided with healthcare and primary care. The agency was set up in 2008 and had three roles to play: (1) to function as a “gatekeeper” and enable all facilities involved in the provision of care to identify the people who would need long-term care, (2) administration of funds to be provided to NGOs, as the funding NGOs received was either pilot funding or mainstream from the Ministry of Health, and (3) implement key initiatives to move back to community-provided care services. She further mentioned that there is also an “Ageing Planning Office” in the Ministry of Health, which oversees the implementation of all ageing strategies.

Ms. Sasat argued that human resources for effectively delivering appropriate health and long-term care to older persons in Thailand needed to be augmented. Concern remains with respect to the lack of skilled professionals with sufficient knowledge to the needs for long-term care of older persons. She argued, therefore, that governments should invest in curriculum development to adequately train professional caregivers such as doctors, nurses, social workers, and volunteers who could assist in community-based care.

Ms. Sasat also mentioned that due to social customs and norms, there is an

expectation in many Asian countries that young people, particularly wives, daughters, and daughters-in-law, must assist and take care of elderly parents. It is often expected from women in the family to withdraw from the labour market to take care of family members in need for care. She called for policies which allowed combining work with the provision of family care, such as providing a care allowance for caretakers,

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promoting work from home or giving special care leave. She also mentioned that the care role often formed a disadvantage for women on the labour market.

Dr. Dey stated that India has a relatively lower proportion of older persons, but

in absolute terms has more than 100 million older persons and older persons are the fastest growing segment of the population. He also emphasized the large disparities in terms of population ageing across states in India, with the ageing process being faster in the Southern states, e.g. Kerala, where the rate of population ageing is similar to Singapore. The phenomenon of both national and international migration has also been exacerbating this population dynamics, as many people have migrated to work in the Middle East, thereby leaving older persons behind. In the North-East, many younger people migrate domestically, leaving older persons behind in rural areas. Therefore, there was a need to prepare better for providing health and long-term care for the large and growing number of older persons. India already designed a National policy on Ageing in 1999, which was reviewed in 2011, but the review was not accepted. In 2015, the National Health Policy was reviewed including a paragraph on 9older persons, focusing on long-term and palliative care. All policies include a reference to the need for providing long-term care. However, the challenges still lie in implementation. For cultural reasons, the family was still considered as the main provider of long-term care. Institutional care for older persons is often not accepted for cultural reasons, even in cases of severe Alzheimer’s disease.

Mr. Dey further explained that surveys had revealed that many older persons

were home-bound, and required a certain level of care. However, financial support for caregivers was still limited. There are some agencies that provide financial support for acute and hospital care. The Ministry of Skill Development also started developing training programmes for caregivers, such as a home help programme which trains people with care skills to take care for older persons at their home. Yet, while these training programmes exist, there is no funding for these workers, so the programme is rather targeted to people from middle and upper classes, who can pay for these services. Policies on long-term care in India should target primarily at home care and improve the quality of services for people who are home or bed-bound.

Although demand for care is increasing, specialized caregiver facilities and

financial mechanisms to support long-term care are extremely limited in the public sector. The private health care dedicated for older persons is also less developed. Dr. Dey pointed out that this resulted from social and cultural factors in India, where assisting and caring for older persons were considered as the responsibility of the family. Since home-based care has many limitations, there should be a comprehensive and uniform long-term care program, which would provide financial resources and train caregivers for home based care as well as long-term care. Furthermore, he stated that the programme should have good quality and coordination with the health system, to ensure accessibility to appropriate medical care for chronic or acute health problems.

Dr. Holmes emphasized the role of projections for long-term care demand:

projections were necessary to adequately plan the need for care and, in addition, they served useful awareness-raising purposes. The projections needed to take into account

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several variables such as pace of population aging, proportion of the oldest-old, dependency ratio, marriage trend, and the number of single households – all variables which influence the demand for long-term care. She argued that statistics departments in different countries should be encouraged to improve their capacities to precisely estimate and record all necessary data at an appropriate level of disaggregation. There should be community mapping at the local level, taking into account data that evidences the needs for long-term care from each individual household. She also emphasized that communication and coordination among the ministries were required to manage and finance long-term care.

Dr. Holmes further argued that healthy ageing policies and taking a life-course

approach were important to keep people fit for a longer time and to reduce the demand for long-term care. She also pointed out that preparing for old-age was important. In some cases, people’s health declined gradually, but in other cases the need for care can come up all of a sudden due to a stroke or a broken hip as a result of a fall. He also pointed out that technology can reduce the demand for long-term care and support older persons in their daily life.

During the subsequent discussions, experts noted the importance of viewing

older persons as resources, including in caregiving roles with younger older persons providing care for the oldest in the family as well as for grandchildren. Older persons associations and inter-generational clubs could therefore play an important role in the provision of care, particularly in rural areas; in many areas services provided by older persons associations were well ahead of institutionalized long-term care services. Several countries in the region already had good policies that included the services of older persons associations. Furthermore, older persons clubs also provided services beyond care, such as selling food, which also provided a business opportunity for older persons associations.

It was also raised that care services were mainly available in urban centres, with

little availability in rural areas. There was a need to provide more care services to the rural population, particularly farmers, as their children often migrated to the cities. However, some others pointed out that in some cases rural areas were better positioned, because of the existence of such older persons associations, while care provision in urban slums was extremely difficult.

Some participants also raised the need for post-retirement planning among the

middle-aged groups. Many took it for granted that their children would provide care for them when they were old, but re-thinking was required.

It was also pointed out that ageing policies also had to look at risks for requiring

long-term care in the future. There were not only health risks, but also social risks. Those without a family support system were at higher risk of requiring long-term care by other providers.

The need for training human resources to provide care for older persons was also

re-emphasized in the discussion. Some countries currently relied on migrant domestic

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workers in providing care for older persons. Some participants expressed the view that this was not sustainable as the supply of migrant domestic workers would decrease in the future. It was also mentioned that, for example Singapore, subsidized the training of caregivers and encouraged career-switches. Others expressed the view that migrant workers could play an important role in the provision of care. Therefore, a curriculum needed to be developed to train foreign workers adequately.

It was also suggested that a model of “home-style institutional care” could be

developed, which could be an institution providing home-style accommodation but provide professional rehabilitation services.

With regards to financing long-term care, it was noted that it is easier to

introduce long-term care insurance if there is already high coverage of health insurance. Then, long-term care insurance can be extended to those who already have a health insurance. In this context, it was emphasized that working towards universal access to healthcare should be a key priority.

The gender aspects of current models of care provision were also emphasized.

Family care was usually provided by women in the family without remuneration. Ways had to be found to better recognized women’s unpaid care services.

Participants also discussed data requirements to undertake projections on future

demand for long-term care. More data were required on the burden of disease and general data on morbidity. It was suggested that demographic departments of universities could be approached to design models to project future needs for long-term care. The role of household surveys to project future care needs was also emphasized.

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IV. Process of the Third review of the Madrid International Plan of Action on Ageing

The session was moderated by Mr. Eduardo Klien (HelpAge) and featured an

interactive panel discussion focusing on the process of the Third Regional Review of the MIPAA and linkages to the 2030 Agenda on Sustainable Development and the contributions of different stakeholders to the process. The session featured presentations on Ageing in Asia and the Pacific and the Third MIPAA Review Process and Linkages with the 2030 Agenda for Sustainable Development by Ms. Vanessa Steinmeyer, Population Affairs Officer, Social Development Division, ESCAP; the Role of Sub regional Organizations and the Kuala Lumpur Declaration by Ms. Thi Minh Duc Ha, Deputy Director-General, International Cooperation Department, Ministry of Labour, Invalids and Social Affairs, Viet Nam; the Role of Civil Society and Potential Contribution to MIPAA Review by Mr. Mathew Cherian, Chief Executive, HelpAge India; and the Role of Parliamentarians in the MIPAA Review by Mika Marumoto, Executive Director, Asian Forum of Parliamentarians on Population and Development.

Ms. Steinmayer, provided an overview of population ageing in Asia and the

Pacific, highlighting population trends across the region, such as the increasing number of older persons in the whole region, but that population ageing in East and North-East Asia was more advanced than in other sub regions. She also stressed that ageing was closely related to gender issues, as there were more older women than men and the gap increased steadily with age. She also emphasized that ageing should be considered positively, as older people formed an important resource for every country, but adequate policies had to set in place to harness this resource.

Ms. Steinmayer then explained the strategy for the Third Regional Review of the

Madrid International Plan of Action on Ageing (MIPAA). Through ECOSOC resolution 2015/5, regional commissions received a strong mandate to conduct the third regional review process in 2017. The third regional review is envisaged for September 2017, and the outcome would feed into a global review in 2018. ESCAP has already started preparations for the third review process. She further explained the linkages between MIPAA and the 2030 Agenda for Sustainable Development, which is a comprehensive development agenda with a focus on reducing inequality and reaching all population groups and made specific reference to older persons in some instances. Therefore, both action plans were complementary.

Ms. Thi Minh Duc Ha, discussed the Kuala Lumpur Declaration on Ageing,

which was adopted by the 27th ASEAN Summit in November 2015 in Malaysia. The Kuala Lumpur Declaration on Ageing recognizes that an increase in the proportion of older persons in the population will require the adaptation of health care and social support systems to meet this emerging challenge. The Kuala Lumpur Declaration articulates the existing high-level political commitment of ASEAN member states to (i) recognize and protect rights; (ii) ensure and promote welfare; (iii) address the needs and realize the potentials of older persons in the region. It is also complementary to MIPAA in that they both advocate a shared responsibility approach in preparation for healthy, active and productive ageing. She further highlighted the alignment between regional

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and international initiatives on population ageing. The ASEAN community building initiatives are complementary to the 2030 Agenda on Sustainable Development, with both agendas clearly articulating that no one should be left behind, and those furthest behind should be reached first. She further explained that the ASEAN Socio-Cultural Community (ASCC) Blueprint 2025 policies aimed at engaging and benefitting its people, and considered the promotion and protection and human rights as a key instrument. In this context, the key regional instruments affirming and promoting the rights and welfare of older persons in ASEAN are the ASEAN Human Rights Declaration (2012), the ASEAN Declaration on Strengthening Social Protection (2013), the Brunei Darussalam Declaration on Strengthening Family Institutions: Caring for the Elderly (2010), the Regional Framework and Action Plan to Implement the ASEAN Declaration on Strengthening Social Protection (2015), and the Kuala Lumpur Declaration on Ageing: Empowering Older Persons in ASEAN (2015). Within this context, Ms. Ha outlined some opportunities to contribute to the MIPAA review process.

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V. Identifying regional priorities for the implementation of the Madrid International Plan of Action on Ageing and emerging areas

Advancing health and well-being into old age

This session was moderated by Ms. Lubna Baqi, Deputy Regional Director,

UNFPA, and featured an interactive panel discussion with questions to highlight national experiences and key elements for policy guidance. The panellists were Ms. Anjana Bhushan, WHO-WPRO, and Mr. Soonman Kwon, Chief Health Adviser, Asian Development Bank. The following contributed as discussants: Ms. Mo Lixia, Deputy Director General, Department of Family Development, National Health and Family Planning Commission (NHFPC), China; Dr. Aparajit Ballav Dey, Professor, All India Institute of Medical Sciences, India; Mr. Jian’an Li, President of International Society of Physical and Rehabilitation Medicine and Foreign Associate of Institute of Medicine, USA.

Ms. Bhushan delivered a presentation on the WHO (WPRO) Regional Strategy on

health for older persons. She pointed at improvements in life expectancy and that the quality of those additional years in life expectancy largely depended on their health status. The healthy status of older persons typically depended on genetic inheritance, residence location, health behavior and access to health care. In order to achieve the objectives of a healthy ageing process, WHO is committed to support member States in addressing ageing and health within the context of the Regional Framework for Action on Ageing and Health in the Western Pacific (2014-2019). This is supported and guided by WHO’s action framework for Universal Health Coverage (UHC). There are four action pillars for the regional framework for action on ageing and health: (1) Age-friendly environment through action across sectors; (2) Health ageing promotion through empowering people to maintain health as they grow older, and maximize functional ability and preventing functional decline and ill-health among older persons; (3) Reorient health systems to better respond the needs of older persons; and (4) Strengthen the evidence base on ageing and health.

Mr. Soonman Kwon, presented on the health policy relating to population

ageing in Asia and the Pacific. An overview of the health situation of older persons in the region was first provided, followed by the details in the health systems and policies for older persons in a number of countries. Non-communicable diseases (NCDs), including lung cancer, diabetes or chronic kidney disease, showed the highest growth; with about 75 per cent of these deaths occurring among people aged 60 years and over. Key risk factors included suboptimal diets and smoking. The growth of health spending has exceeded economic growth in many Asian-Pacific countries, with “ageing” accounting for one-third of health spending growth in developed countries. In the context of these challenges, he highlighted for key issues related to the health systems in the region: Firstly, the health systems in many countries in the region are not well placed to respond to an increase in NCDs and ageing because of an overreliance on hospital care with weak gatekeeping and referral systems. Secondly, most countries have no long-term care system beyond hospitals and the family. At the same time, the spending on pharmaceuticals is excessive, due to over-prescription and

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inefficient procurement. Thirdly, Universal Health Care is one of the most viable solutions to improve the health status of older persons, and there is a need for increased government commitment in this regard. In particular, there is a need for sustainable financing mechanisms in the form of schemes funded by contributions and public sources (government tax or social health insurance). Lastly, it is highly recommended to extend the benefit package of existing schemes and essential medicines list to cover NCDs and services for older persons.

Ms. Lixia noted that the health conditions of older persons have to be improved:

Currently the population of older persons of 60 years or older spends two-thirds of their remaining life needing care; health service systems, thus, need to be strengthened, such as geriatric hospitals, rehabilitation hospitals and nursing homes. Other priorities include the provision of integrated care, to strengthen human resource development and the use of information technology services.

Mr. Jian’an discussed the Nanjing project to provide long-term care for older

persons “5 million homes” – whereby homes for older persons are set up to provide home-based care linked with hospital services under one roof. The project has several components including research on health status of older persons for the Government. Insurance companies in China finance this model and use it as a national model for the whole country. This also serves to increase insurance coverage.

Dr. Dey argued that priorities for healthy ageing include adapting health systems

to the challenges of ageing. The focus on capacity-building, building of facilities and skill development must continue. Providing universal health care (UHC) will be most essential to older persons – lack of access to healthcare make cost of healthcare expensive for older persons. In India, means-testing is currently used for access to healthcare. Sometimes, though, people are placed above poverty line and then have to pay for access to healthcare after which hospitalization drives the family below poverty line. These situations must have appropriate remedies and policy responses.

In the subsequent discussion, participants stressed the need for providing

universal health care. While some expressed the opinion that providing universal health care already fulfilled a large part of the priority direction on health and well-being of MIPAA, others emphasized that MIPAA also encouraged a whole-of-systems and a whole-of-government approach.

Participants raised the issue of how to integrate and subsequently finance the

various dimensions of care. Financing can be done either through taxation or insurance schemes. The cost of chronic diseases needed to be factored into the equation, and the rural/urban divide should also be considered in the policy design process.

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Older Persons and Development with a focus on income security

This session on Older Persons and Development with a focus on income security

was moderated by Ms. Kyung Hee Chung, Head, Research Center on Ageing Society, KIHASA and featured an interactive panel discussion with questions to highlight national experiences and key elements for policy guidance. The panel members included

Gemma Estrada, Senior Economics Officer, Asian Development Bank; Mr. Josefa Koroivueta, Permanent Secretary, Ministry for Women, Children and Poverty Alleviation, Fiji; Ms. Ruhaini Binti Zawawi, Director, International Relations and Policy Division, Department of Social Welfare, Malaysia; and Mr. Mathew Cherian, Chief Executive, HelpAge India.

Ms. Estrada provided an overview of public pension systems in emerging Asia,

and argued that old-age income support will be one of developing Asia’s biggest social and economic challenges in the 21st century. As social changes have weakened family-based old-age support mechanisms, formal pension systems will have to play a bigger role. In contrast to OECD countries, Asia does not yet have mature, well-functioning pension systems. Many Asians, therefore, are at risk of old-age poverty. The biggest challenge for Asian pension systems is limited coverage. The share of the labour force which is covered by pension systems ranges from 11 to 84 per cent, and the coverage rate for working-age population ranges from 8 to 64 per cent. Ms Estrada concluded that many pension systems in the region required reforms. Pension reform must be part of a policy package, and must take into account the overall socio-economic context and overall policy environment in the pension reform process. Given the wide disparity in income levels and existing pension systems, different countries will have different priorities in pension reform. Still, there are common themes which emerge from an analysis of eight countries in the region, and eight urgent and necessary have been identifies as follows: (i) draw up a national blueprint for old-age income support; (ii) build a national consensus on old-age income support through constant dialogue; (iii) set up an independent National Social Security Council (NSSC); (iv) improve transparency, accountability and professionalism; (v) promote equity and sustainability; (vi) achieve adequate retirement income; (vii) mitigate old-age poverty; and (viii) improving returns on pension assets.

Dr. Koroivueta provided an overview of the current situation in Fiji where older

persons comprise about 8 per cent of the population. The Government of Fiji strives to promote inclusiveness, protection, health and an enabling environment for older persons. Promoting rights such as access to healthcare, housing and sanitation, food security and social security is key to the pledge by the Government not to leave anyone behind. Currently in the pipeline is a bill of rights to address the needs of older persons. In addition, Fiji has established a national council of older persons to listen to the voice of older persons, and the Government is now finalizing a 20 year national development plan, which includes – inter alia - protection of older persons. In 2013, a Social Pension Scheme was introduced, through which the Government provides increasing assistance to senior citizens, including a fund for the armed forces, as well as for women who worked in the civil service in the colonial era.

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Ms. Zawawi provided an overview about the current state of social protection in Malaysia. The social protection system includes several pillars, including social assistance measures such as pensions. Ms. Zawawi stated that as Malaysia is not a welfare state, it pursues “an active labour market policy and regards the role of social welfare services as marginal to the development process”. Universal social pension for the elderly is not sustainable in the long run. With the increase in the civil service mandatory retirement age and the Minimum Retirement Age Act 2012, there is an increase in the labour force participation rate of older workers aged between 55 to 60 years old. Minimum wages set at RM900 a month in 2012 (RM800 a month for Sabah & Sarawak) reinforces the financial security that comes with being employed. More, however, has to be done to ensure the financial security of the lifelong poor and at-risk groups such as the disabled, frail and vulnerable who cannot work. The 11th Malaysia plan will streamline social protection for older persons to ensure a better quality of life for its older persons.

Mr. Cherian discussed the situation in India where the poor old do not have any

form of pension. HelpAge focuses on health treatment, but cannot provide pensions. With the Indian constitution specifying the “right to life”, HelpAge India advocates for the right to social security. A social pension injects cash into local economies, thereby giving local people spending power and access to markets which in turn helps drive growth by stimulating consumption, particularly in rural areas. Social pensions are of paramount importance, therefore, as they: (i) protect people from vulnerabilities faced in old age (poverty, unemployment, poor health, lack of family support); (ii) improve older people’s ability to invest in family and livelihood by increasing assets, well-being and capabilities; (iii) support local economies, and (iv) improve social cohesion/prevent social unrest. The challenge for policy makers, within this context of the importance of social pensions, is therefore, the question of how to balance these objectives with their affordability, sustainability and impact.

In the subsequent discussion, the importance of social pensions in several

countries of the Asia-Pacific region was emphasized. It was also mentioned that more data on the use of social pensions would be required. Participants agreed that contributory pensions needed to be further developed and coverage needed to increase. Particular efforts should be made to increase coverage among women and to design pension systems in a way so that they include redistributive elements from higher to lower incomes.

Concerns were expressed with the current lack of sustainability of pension funds

of many countries and the consequent need for governments to take urgent action. Some participants also indicated that in some countries, efforts needed to be made to turn lump-sum benefits into annuities to ensure a monthly income for older persons. Another suggestion was to turn assets into an annuity, such as a reverse mortgage, which was offered in some countries of the region.

Concern was raised that currently, contributory pensions favored those who are already better protected in working-age. Thus, ways had to be found to cover the informal sector with contributory pensions. It was also raised that women were at a

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particular disadvantage with regards to contributory pensions, as their labour force participation in the formal sector is lower than men. Some also expressed the view that economies will tend to be more formalized, once they get wealthier, which would facilitate contributing to pensions. In this context, others emphasized the importance of making available social pensions to those who could not contribute to pensions during their working life.

It was also mentioned that while pensions are an important instrument,

strengthening families so that young people can support their older parents was another possibility of ensuring income security for older persons. Others also mentioned that programmes supporting older persons to earn an income, such as entrepreneurship programmes, could be another way to ensure income security for older persons.

Ensuring enabling and supportive environments including families

This session on ensuring enabling and supportive environments including

families was moderated by Ms. Anjana Bhushan (WHO) and featured an interactive panel discussion with questions to highlight national experiences and key elements for policy guidance. The presenters included the following: Mr. Minwei Zhang, Director of Policy and Research Department, China National Committee on Ageing (CNCA), China; Mr. Khagesh Garg, Director, Ministry of Social Justice and Empowerment, India; Mr. Mohammad Gheidari, Director-General of Zanjan Provincial Office of the State Welfare Organization, Islamic Republic of Iran; Dr. Tengku Aizan Hamid, Director, Malaysia Research Institute of Ageing, Malaysia; and Mr. Suvinda Singapooli, Director, National Secretariat for Elders, Sri Lanka.

Mr. Zhang provided details of the recently initiated regional five-year health

plan of China supporting the environment, medical care, and health security. A legislative framework has been created regarding increasing pension coverage among residents to address the gap in old-age income security. This framework contains administrative laws and recommendations that have helped China to realize full coverage of an old age security system for both urban and rural residents over the past five years. Mr. Zhang stated that this scheme now covers over 859 million participants, making it the largest plan of its kind in the world. The total number of urban basic medicare participants has reached approximately 656 million, while participation in the pension system has reached 627 million. The combination of these systems has reached over 95 per cent of the Chinese population, an impressive accomplishment for a country of its size.

Mr. Zhang highlighted that the basic medical care security is based on its

establishment with the perspective of older persons. The Chinese government has recently expanded this system, supplementing with community care and institutional care, with the ultimate goal to cover the entire retired community. During the past five years, preferential policies for elders were widely enacted and put into effect in China. The majority of these policies have established care for the elderly and destitute, with many organizations and protection agencies ensuring their implementation. Impacts

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have been seen in terms of more inclusive economic, geographic, and transportation systems. Health status has since also increased, as demonstrated by the rise of life expectancy to 76 years.

Mr. Garg discussed the implementation of the National Policy on Older Persons

(NPOP) coordinated by the Ministry of Social Justice and Empowerment in India. This initiative focuses on supporting voluntary organizations through grants, providing shelter and food security. It also aims to strengthen health care systems, health insurance, the training of health care personnel, expansion of mental health services, and raise awareness regarding inter-generational bonding. The National Council of Senior Citizens (NCSrC) is the highest body to advise the Indian Government in the formulation and implementation of policies and programmes for older persons.

The Ministry of Social Justice and Empowerment also runs the Integrated

Programme for Older Persons (IPOP). IPOP has offered old-age homes for destitute older persons, mobile medicare units for older persons living in slums and inaccessible areas, and respite care homes and continuous care homes for older persons seriously ill, requiring continuous nursing care and respite. IPOP currently runs approximately 700 projects, including one on generating awareness on the needs of older persons.

Mr. Garg then outlined several initiatives taken by other ministries in India, such

as the Housing for All (Urban) Mission from the Ministry of Housing & Urban Poverty Alleviation. This mission offers affordable housing in partnership with either the public or private sector.

The Ministry of Health and Family Welfare has implemented the National

Programme for Health Care of the Elderly (NPHCE), providing dedicated health care facilities to the elderly people through state public health delivery systems at primary, secondary and tertiary levels. A total of 300 districts of 24 states and union territories, as well as 13 regional geriatric centres have been covered under the programme. The Ministry of Health and Family Welfare has also implemented the Rashtriya Swasthya Bima Yojana (RSBY) National health insurance scheme for poor families. The beneficiaries under RSBY are entitled to hospitalization coverage for most of the diseases that require hospitalization.

The Ministry of Finance has introduced basic tax exemptions for senior cities, as

well as an Act that provides for a reduction in force insurance on the health of senior citizen parents from taxable income as a way to incentivize the younger generation to look after the medical needs of their parents. The Ministry of Rural Development has introduced National Social Assistance Programmes (NSAP), including an old-age pension scheme and a widow pension scheme.

Mr. Garg then discussed initiatives that offer care and support for caregivers in

India, such as the National Initiative on Care for Elderly (NICE) project implemented by the National Institute of Social Defence (NISD).

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Mr. Gheidari opened his discussion on the Islamic Republic of Iran’s experience of population ageing and attempts for age-friendly environments by looking at the demographic transition. So far, the Islamic Republic of Iran has taken several major steps to implement MIPAA in terms of legislations, policy-making and interventions for older persons. Because of the multi-sectorial nature of ageing issues, the National Council for Older Persons has been established and prepared a National Strategic Plan for Older Persons (NSPO), which was recently reviewed with the support of UNFPA and HelpAge International. The overall objective of NSPO is to promote respect to older persons, ensure their dignity, improve mental and physical health, protection and welfare care, and security of the elderly. Mr. Gheidari further described how Iran is creating age-friendly environments and communities by taking positive steps to provide enabling environments. However, further improvement and efforts are still needed, and challenges remain.

Dr. Tengku Aizan Hamid emphasized that there are many guiding blueprints

and national policies on ageing in Malaysia. These include the National Policy for the Elderly (1995) and the National Policy for Older Persons (2011) from the Ministry of Women, Family & Community Development. The Ministry of Health in Malaysia also put out a National Policy for Older Persons in 2008, and the National Day of Older Persons has been celebrated on 1 October in Malaysia since 1992. She outlined the five-dimension framework for ageing: economy for productive ageing, health for healthy ageing, social for active ageing, spiritual for positive ageing, and environment for supportive ageing.

In 2011, the National Policy for Older Persons was enacted in Malaysia after the

National Policy for the Elderly ended in 2005 under the Ministry of Women, Family and Community Development. This policy works together with the National Health Policy for Older Persons 2008 under the Ministry of Health. The policy focuses on empowering individuals, families and communities through provision of elderly-friendly services and enabling environments to improve the well-being in old age. Dr. Hamid concluded by outlining a number of ways forward for Malaysia.

Mr. Singapoli explained that the Ministry of Social Empowerment and Welfare in

Sri Lanka, coordinated the policies aimed at providing services to vulnerable individuals, including persons with disabilities, senior citizens and single-parent families. The National Secretariat for Elders was established under the protection of the Rights of Elders Act No. 9 of 2000, and functions under the Ministry of Social Empowerment and Welfare. It is the primary administrative body engaged in implementing programmes approved by the Council of Elders.

Mr. Singapoli explained that the National Policy for Elders in Sri Lanka was

based on the recommendations of the Second World Assembly of Ageing held in Madrid. The National Charter and National Policy for Elders were adopted by the Cabinet of Ministers in the year 2006, with main focuses on health, social welfare and economic support. Common ageing issues in Sri Lanka include participation in development, isolation in homes, low level of geriatric services, policy and legal

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provisions, political commitment, financial constraints, and achieving the goals agreed upon in the MIPAA.

Mr. Singapoli then focused his talk on Priority Direction 3: Ensuring enabling

and supportive environments and highlighted a number of initiatives, such as discounts for certain goods and services, a loan scheme for older persons with low income and self-employment grants. An elder welfare fund has also been established, along with elder committees that facilitate an elder cooperative society in Sri Lanka. In terms of care and support for caregivers, Sri Lanka offers a geriatric diploma programme for medical officers, as well as gerontology and counselling diploma for all Elder Rights Promotion officers. Sri Lanka also provides cataract lenses and hearing aids for low income elders, and helps to facilitate home upgrades to elders in need. A maintenance board was established to address neglect, abuse and violence experienced by older persons. Mr. Singapoli concluded by providing some suggestions for enhancing international and regional partnerships as well as capacity-building opportunities for government officers and stakeholders. The sharing of knowledge is essential, as is empowering elders for active participation.

In the subsequent discussion, several participants pointed at the gap between

policies and legislation and their implementation. In many cases, the legislation was already there, but their implementation was lagging behind. For that reason, some country experts explained that their countries were focusing on implementation of existing legislation rather than passing new laws and policies. As an example, India now passed detailed guidelines on improving public transport, making it disability and age accessible. It was also pointed out that societies had to change to guarantee the rights of older persons.

It was also discussed how to promote inter-generational solidarity. While some

suggested laws making it compulsory that young people look after their parents, others expressed the view that this could not be regulated by law. Some suggested promoting activities involving different generations and providing other incentives to promote inter-generational solidarity.

It was also suggested that Governments engage with civil society in providing

more conducive environments for older persons.

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VI. Recommendations

In order to come discuss the recommendation to further implement the Madrid International Action, three working groups were constituted to discuss the three key priorities areas of MIPAA namely: (i) advancing health and well-being into old-age; (ii) older persons and development with a focus on income security; and (iii) ensuring enabling and supportive environments including families. These were meant to inform the framing of the agenda and the key issues to be highlighted as part of the Third Regional Review of MIPAA. In each of the working groups, key priorities, challenges, and emerging priorities in policies and programmes were discussed. The following specific recommendations were made in the working groups:

1. Advancing health and well-being into old-age

a) Current priority areas in implementing the Madrid International Plan of Action on Ageing

(i) Establishing systems for the long-term care of older persons. In order to do

this, a needs assessment needs be conducted and there should be an appropriate mix of services and providers, such as family, civil society, private and public providers, home-based, institutional, and community care services;

(ii) Working further towards universal access to healthcare would be important to address the needs of older persons;

(iii) Paying increased attention to non-communicable diseases;

(iv) Coordinating and integrating systems health care and social care. Further capacity building is required to provide healthcare meeting the needs of older persons as well as providing long-term care;

(v) Innovations in the provision of care should be promoted, such as the use of technology or innovative models of care provision and financing.

b) Challenges encountered in implementing the Madrid International Plan of

Action on Ageing (i) Lack of awareness of the health challenges of population and the need to

address specific needs of older persons in the healthcare system;

(ii) Monitoring and evaluation of measures in implementing the Madrid International Plan of Action is limited, thus it is a challenge to evaluate their effectiveness;

(iii) The lack of high-level ministerial coordination is a challenge in advancing health and well-being into old age;

(iv) Limited human resources and adequately trained staff is a challenge in the provision of care for older persons;

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(v) Adequately addressing the changing role of families in the provision of care.

c) Emerging priority areas in the implementation of the Madrid International Plan

of Action on Ageing (i) There is a need to promote intergenerational solidarity and increase

awareness on the health and care needs of older persons;

(ii) More emphasis on providing self-care as well as on peer education should be given;

(iii) Further priority should be given to actual implementation of existing good policies;

(iv) A human rights-based approach should be considered in designing and implementing policies on health and well-being in old age;

(v) Further attention needs to be given to policy coherence between health and welfare policies;

(vi) More attention should be given to age-specific health issues which tend to be neglected so far.

2. Older persons and development with a focus on income security

a) Current priority areas in implementing the Madrid International Plan of Action on Ageing (i) Increasing coverage of pensions among to the poor/informal sector and

women;

(ii) Promote active ageing and skills development of older persons so they can find employment or start entrepreneurial activities – microfinance/ loan schemes for income generation or promoting farming and agriculture;

(iii) Promoting financial knowledge among older persons – allowing them to invest their savings;

(iv) Providing a 3-tier system of income support for older persons: contributory pensions, social pensions, especially for those older people who cannot work and/or have no contributory pension, and private pensions;

(v) Considering older persons as an opportunity – increasing the retirement age and abolishing the mandatory retirement age;

(vi) Convert non-paid jobs into remunerated jobs;

(vii) Designing national-level institutions to cope with population ageing or have any other body responsible for implementing ageing policies.

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b) Challenges encountered in implementing the Madrid International Plan of Action on Ageing (i) There is often a gap between policies and implementation; in implementing

policies, a challenge is how to sequence implementation of different measures;

(ii) Different ministries need to be involved in implementing policies for income security of older persons – coordination between Ministries can be a challenge as well as encouraging all Ministries to participate actively;

(iii) Lack of data to provide evidence – baseline surveys available, but lack of coordination (e.g. to have better information on pensions coverage, beneficiary characteristics, and who is left behind);

(iv) Challenges lie in involving the private sector in providing pensions, including in providing incentives to the private sector to design adequate financial products;

(v) Some countries prefer targeting social assistance to poor older people, but how to target also avoiding leakage and corruption is a challenge;

(vi) There is often lack of awareness of existing pensions schemes, particularly on availability and the benefits of contributing to a voluntary contributory scheme;

(vii) Managing the payment of social pensions, as several different Ministries are involved;

(viii) Addressing low benefit levels of prevailing pension systems while keeping budgetary constraints in mind.

c) Emerging priority areas in the implementation of the Madrid International Plan

of Action on Ageing (i) Addressing the needs of the current generation of older persons, who are

often not covered by pension schemes as in many cases they were established relatively late;

(ii) Changing mindsets of the concept of a retirement age and have equal retirement ages for men and women, which is required for sustainable pension funds.

3. Ensuring enabling and supportive environments including families a) Current priority areas in implementing the Madrid International Plan of Action

on Ageing (i) Promotion of sustainable community-based organizations (older persons’

associations and intergenerational clubs);

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(ii) Provision of special measures to enable access of older persons to infrastructure, services and transport;

(iii) Mainstreaming older persons’ reintegration into families;

(iv) Ensuring high-quality of service delivery through development of standards and adequate monitoring mechanisms;

(v) Empowering older persons through knowledge to extend health status and manage non-communicable diseases (NCDs).

b) Challenges encountered in implementing the Madrid International Plan of

Action on Ageing (i) Ensuring financing and human resources for necessary changes at policy

and institutional levels;

(ii) Ensuring awareness of ageing issues at all levels of society;

(iii) Empowering families to support older persons;

(iv) Developing mechanisms to ensure guardianship of older persons suffering from dementia;

(v) Improving functional capacity of older persons to adapt to environments and improve quality of life, including through intergenerational support in areas such as technology;

(vi) Encouraging and enabling life-long learning, including through “Universities of the Third Age” and mutual learning opportunities;

(vii) Ensuring age-friendly urban spaces.

c) Emerging priority areas in the implementation of the Madrid International Plan of Action on Ageing (i) Encouraging increased use of new technologies, especially ICT and mobile

technologies, to expand accessibility of services and manage health, overcoming physical barriers, including through improving capacities and awareness of older persons of technologies ;

(ii) Legal provisions for protection of older persons from abuse and upholding the rights of older persons

(iii) Development of leadership structures in government to address enabling environments.

VII. Closing of the Regional Expert Forum

Following the working groups reporting back to plenary, Mr. Srinivas Tata, on behalf of ESCAP, Ms. Yoriko Yasukawa, on behalf of UNFPA and Mr. Eduardo Klien on behalf of Helpage delivered short statements, and thanked all participants for their active contributions and high degree of commitment.

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Annex I

List of Participants

COUNTRIES

CAMBODIA Mr. Monorum Som, Deputy Director of Elderly Welfare Department, and Head of Technical Division of Cambodia National Committee for the Elderly, Ministry of Social Affairs Veterans and Youth Rehabilitation, Phnom Penh, Email: monorum_som@yahoo.com

CHINA Ms. Lixia Mo, Deputy Director General, Department of Family Development, National Health and Family Planning Commission (NHFPC), Beijing, Email: molixia1968@qq.com, 13911199111@163.com Ms. Chunmei Zheng, Division Chief, Department of Family Development, National Health and Family Planning Commission (NHFPC), Beijing, Email: 1169105685@qq.com Ms. Hongyan Xiao, Deputy Chief, Programme Section, International Department, China National Committee on Ageing (CNCA), Beijing, Email: xhy@cncaprc.gov.cn Mr. Minwei Zhang, Director of Policy and Research Department, China National Committee on Ageing (CNCA), Beijing, Email: zhangminwei@cncaprc.gov.cn Ms. Wei Ma, Programme Officer, Department of International Cooperation, China Population and Development Research Center, Beijing, Email: mawei49@163.com

FIJI

H.E. Rosy Sofia Akbar, Minister, Ministry of Women, Children and Poverty Alleviation, Suva, Email: rosy.akbar@govnet.gov.fj Ms. Dilitiana Baleinabuli, Senior Policy and Research Officer, Ministry for Women, Children and Poverty Alleviation, Suva, Email: dbaleinabuli@govnet.gov.fi Mr. Josefa Koroivueta, Permanent Secretary, Ministry of Women, Children and Poverty Alleviation, Suva, Email: josefa.koroivueta@govnet.gov.fj

INDIA

Mr. Khagesh Garg, Director, Ministry of Social Justice and Empowerment, New Delhi, Email: khagesh.g@gov.in

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INDONESIA Mr. Mu’man Nuryana, Acting Head, Board of Education, Research and Social Extension, Senior Advisor to the Minister on Social Accessibilities, and SOWSWD Focal Point Indonesia, Ministry of Social Affairs of the Republic of Indonesia, Jakarta, Email: nuryanamuman@yahoo.com

IRAN, ISALAMIC REPUBLIC OF

Mr. Mohammad Mohammad Gheidari, Director General of Zanjan Provincial Office of the State Welfare Organization, Zanjan, Email: mohammad.m3400@yahoo.com

LAO PEOPLE’S DEMOCRATIC REPUBLIC Mr. Sisavath Khomphonh, Deputy Director, Ministry of Labour and Social Welfare, Vientiane, Email: sisavathkhomphonh@yahoo.com

MACAO, CHINA

Mr. U Keong Cheang, Senior Officer of Senior Service Division, Social Welfare Bureau, Government of Macao SAR, Email: cukeong@ias.gov.mo Mr. Sio Un Choi, Head of Department of Social Solidarity, Social Welfare Bureau, Government of Macao SAR, Email: clarance@ias.gov.mo

MALAYSIA

Ms. Nor Fathiah Raduwan, Assistant Secretary, Ministry of Women, Family and Community Development, Putrajaya, Email: fathiah@kpwkm.gov.my Ms. Ruhaini Zawawi, Director, International Relations and Policy Division Department of Social Welfare, Putrajaya, Email: ruhainiz@jkm.gov.my Ms. Nafishah Abdullah, Senior Assistant Director, National Population and Family Development Board, Kuala Lumpur, Email: nafishah@lppkn.gov.my Ms. Aizan Tengku Abdulhamid, Director, Malaysia Research Institute of Ageing, Universiti Putra Malaysia, Serdang, Email: aizan@upm.edu.my

REPUBLIC OF KOREA

Ms. Kyung Hee Chung, Head, Research Center on Ageing Society, Korea Institute for Health and Social Affairs, Sejong-si, Email: khlc@kihasa.re.kr Ms. Yun Kyung Lee, Research Fellow, Korea Institute for Health and Social Affairs, Sejong-si, Email: yklee@kihasa.re.kr

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RUSSIAN FEDERATION Mr. Andrei Moskvin, Second Secretary, Ministry of Foreign Affairs, Moscow, Email: amoskvin@mid.ru

SRI LANKA

Mr. Suvinda Samarakoon Singapooli, Director, National Secretariat for Elders, Ministry of Social Empowerment and Welfare, Bataramulla, Email: dirnse@gmail.com, nsemss@gmail.com

THAILAND

Ms. Siriwan Aruntippaitune, Director, Department of Older Persons, Ministry of Social Development and Human Security, Bangkok, Email: siriwan9999@hotmail.com Ms. Arpar Ratanapitak, Senior Professional Social Worker, Department of Older Persons, Ministry of Social Development and Human Security, Bangkok, Email: pumja@hotmail.com

VIET NAM Ms. Thi Minh Duc Ha, Deputy Director General, International Cooperation Department, Ministry of Labour, Invalids and Social Affairs, Hanoi, Email: duc.htm@icd-molisa.gov.vn

____________________________

OTHER EXPERTS Mr. Yi Chen, Board Chairman, Zhongshan College, Nanjing, China, Email: chenyi1953@126.com

Mr. Mathew Cherian, Chief Executive, HelpAge India, New Delhi, India, Email: mathew.cherian@helpageindia.org Mr. Hyunse Cho, President, HelpAge Korea, Seoul, Republic of Korea, Email: hyun@helpage.or.kr Dr. A.B. Dey, Professor and Head, Department of Geriatric Medicine, All India Institute of medical Sciences (AIIMS), New Delhi, India, E-mail: abdey@hotmail.com Mr. Peng Du, Director, Institute of Gerontology, Renmin University of China, Beijing, China, Email: dupeng415@aliyun.com Ms. Gemma Estrada, Senior Economics Officer, Economic Research and Regional Cooperation Department, Asian Development Bank, Manila, Philippines, Email: gestrada@adb.org Mr. Li Jian'an, President of International Society of Physical and Rehabilitation Medicine and Foreign Associate of Institute of Medicine, USA, Nanjing, China, Email: lijianan@carm.org.cn Mr. Eduardo Klien, Regional Director, HelpAge International East Asia/Pacific, Chiang Mai, Thailand, Email: eduardo@helpageasia.org

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Mr. Soonman Kwon, Chief Health Advisor, Sustainable Development and Climate Change Department, Asian Development Bank (ADB), Manila, Philippines, Email: skwon@adb.org Ms. Mika Marumoto, Executive Director, Asian Forum of Parliamentarians on Population and

Development (AFPPD), Bangkok, Thailand, Email: mika@afppd.org

Mr. Peter McGeachie, Regional Director, HelpAge International South Asia Office, Kathmandu, Nepal, Email: peter.mcgeachie@helpagesa.org Ms. Kim Choo Peh, Chief, Programmes, Hua Mei Centre for Successful Ageing, Tsao Foundation, Singapore, Email: kimchoo@tsaofoundation.org Ms. Wendy Rosalind Holmes, Independent International Public Health Consultant, Sri Lanka, Email: wendyholmes101@gmail.com

Ms. Siriphan Sasat, Associate Professor, Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand, Email: sisasat@gmail.com

__________________

UNITED NATIONS BODIES, SPECIALIZED AGENCIES

AND RELATED ORGANIZATIONS

UNITED NATIONS POPULATION FUND (UNFPA)

UNFPA, Asia and the Pacific Regional Office

Ms. Yoriko Yasukawa, Regional Director, Bangkok

UNFPA, Asia and the Pacific Regional Office

Ms. Lubna Baqi, Deputy Regional Director, Bangkok, Email: baqi@unfpa.org

UNFPA, Asia and the Pacific Regional Office

Mr. Christophe Lefranc, Technical Advisor on Census and Data, Bangkok, Email: lefranc@unfpa.org

UNFPA, Republic of Iran Mr. Kambiz Kabiri, Programme Analyst, Tehran Email: kabiri@unfpa.org

WORLD HEALTH ORGANIZATION (WHO)

WHO, Philippines Ms. Anjana Bhushan, Coordinator Equity and Social Determinants, Division of Health Systems, Regional Office for the Western Pacific, World Health Organization (WHO), Manila, Email: bhushana@wpro.who.int

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ECONOMIC AND SOCIAL COMMISSION FOR ASIA AND THE PACIFIC (ESCAP)

SOCIAL DEVELOPMENT DIVISION

Mr. Kaveh Zahedi

Deputy Executive Secretary for Sustainable Development of ESCAP and Officer-in-Charge, a.i. Social Development Division

Mr. Srinivas Tata Chief, Social Policy and Population Section, Social Development Division

Ms. Vanessa Steinmayer Population Affairs Officer, Social Development Division

Ms. Soo Yeob Hyun NRL Expert, Social Development Division

Mr. Paul Tacon Social Affairs Officer, Social Development Division

Mr. Tristram Price Associate Social Affairs Officer, Social Development Division

Ms. Channe I. Oguzhan Associate Social Affairs Officer, Social Development Division

Ms. Lawan Uppapakdee Research Assistant, Social Development Division

Ms. Orani Potpornchai Programme Assistant, Social Development Division

DIVISION OF ADMINISTRATION

Ms. Chetna Lakhoo-Verbeek Chief, Conference Management Unit

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Annex II Programme

Tuesday, 12 July 2016

08:30 – 09:00 Registration

09:00 – 10:00

Session 1: Opening

Welcome remarks by

• Mr. Srinivas Tata, Chief, Social Policy and Population Section, ESCAP

• Ms. Yoriko Yasukawa, Regional Director, UNFPA

• Mr. Eduardo Klien, Regional Director, HelpAge

• Ms. Mo Lixia, Deputy Director General, Department. of Family Development, National Health and Family Planning Commission, China

Keynote speech:

Population ageing in Asia and the Pacific – challenges, opportunities and gender

aspects, H.E. Rosy Sofia Akbar, Minister for Women, Children and Poverty

Alleviation, Fiji

• Presentation on objectives and programme of the Forum, ESCAP

10:00 - 10:20 Refreshment break and photo session

10:20 – 12:00

Session 2: Long-term care for older persons in the Asia-Pacific region

Interactive panel discussion with questions to highlight national

experiences and key elements for policy guidance

Moderator: Mr. Srinivas Tata, ESCAP

Panel discussion:

• Mr. Du Peng, Professor, Renmin University, China

• Ms. Peh Kim Choo, Tsao Foundation, Singapore

• Ms. Siriphan Sasat, Associate Professor, Chulalongkorn University, Thailand

• Dr. Aparajit Ballav Dey, Professor, All India Institute of Medical Sciences, India

• Dr. Wendy Holmes, International Public Health Consultant, Sri Lanka

Q&A and discussion

12:00 – 13:30 Lunch (buffet lunch served)

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13:30 – 14:45

Session 3:

Process of the Third review of the Madrid International Plan of Action

on Ageing

Moderator: Mr. Eduardo Klien, Regional Director, HelpAge

• Ageing in Asia and the Pacific and the third MIPAA review process

and linkages with the 2030 Agenda for Sustainable Development,

ESCAP

• Role of sub regional organizations and the Kuala Lumpur

Declaration, Ms. Thi Minh Duc Ha, Deputy Director-General,

International Cooperation Department, Ministry of Labour, Invalids

and Social Affairs, Viet Nam

• Role of civil society and potential contribution to MIPAA review:

Mr. Mathew Cherian, Chief Executive, HelpAge India

• The role of parliamentarians in the MIPAA review, Mika

Marumoto, Executive Director, Asian Forum of Parliamentarians on

Population and Development

Q & A and discussion

14:45 – 15:00 Refreshment break

15:00 – 16:30

Session 4:

Identifying regional priorities for the implementation of the Madrid

International Plan of Action on Ageing and emerging areas

Priority direction : Advancing health and well-being into old age

Objective of session: To agree on regional priority areas to be addressed

within this pillar and identify emerging areas

Moderator: Ms. Lubna Baqi, Deputy Regional Director, UNFPA

• Regional Strategy on health for older persons, Ms. Anjana Bhushan,

WHO-WPRO

• Priorities on health for older persons, Mr. Soonman Kwon, Chief

Health Adviser, ADB

Discussants:

• Ms. Mo Lixia, Deputy Director General, Department of Family

Development, National Health and Family Planning Commission

(NHFPC)

• Dr. Aparajit Ballav Dey, Professor, All India Institute of Medical Sciences, India

• Mr. Jian’an Li, President of International Society of Physical and Rehabilitation Medicine and Foreign Associate of Institute of Medicine, USA

Q&A and discussion

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Wednesday, 13 July 2016

09:00 – 10:15 Session 5:

Identifying regional priorities in implementation of the Madrid

International Plan of Action on Ageing and emerging areas (cont’d)

Priority direction II: Older Persons and Development with a focus on

income security

Purpose of the session: To agree on regional priority areas to be addressed

within this pillar and identify emerging areas

Moderator: Ms. Kyung Hee Chung, Head, Research Center on Ageing

Society, KIHASA

Presenters:

• Overview of pension systems in Asia-Pacific, Gemma Estrada,

Senior Economics Officer, ADB

Discussants:

• Mr. Josefa Koroivueta, Permanent Secretary, Ministry for Women,

Children and Poverty Alleviation, Fiji

• Ms. Ruhaini Binti Zawawi, Director, International Relations and

Policy Division, Department of Social Welfare, Malaysia

• Mr. Mathew Cherian, Chief Executive, HelpAge India

Q&A and discussion

10:15 – 10:30 Refreshment break

10:30 – 12:00 Session 6:

Identifying regional priorities in implementation of the Madrid

International Plan of Action on Ageing and emerging areas (cont’d)

Priority direction 3: Ensuring enabling and supportive environments

including families

Purpose of the session: To agree on regional priority areas to be addressed

within this pillar and identify emerging areas

Moderator: Ms. Anjana Bhushan, WHO

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Panellists:

Presentations on country policies on ageing

• Mr. Minwei Zhang, Director of Policy and Research Department,

China National Committee on Ageing (CNCA), China

• Mr. Khagesh Garg, Director, Ministry of Social Justice and

Empowerment, India

• Mr. Mohammad Gheidari, Director-General of Zanjan Provincial

Office of the State Welfare Organization, Islamic Republic of Iran

• Dr. Tengku Aizan Hamid, Director, Malaysia Research Institute of

Ageing, Malaysia

• Mr. Suvinda Singapooli, Director, National Secretariat for Elders,

Sri Lanka Q&A and discussion

12:00 - 13:30 Lunch break

13:30 – 15:00 Session 7:

Identifying regional priorities in implementation of the Madrid

International Plan of Action on Ageing and emerging areas

(Group Work)

Groups to be structured along three Priority Directions

Resource persons for groups will include experts as well as experts from WHO,

HelpAge, UNFPA, ILO and ESCAP

Chairs will be chosen from among Government Experts

Working group discussions will focus on key priorities under each priority

direction of MIPAA and emerging areas 15:15-15:30 Refreshment break

15:30 – 16:30 Closing session

• Reporting of group work to the plenary

• Summary and the way forward

• Closing remarks by ESCAP, UNFPA and HelpAge.